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Author
Topic: Low CD4's after 2 years on meds (Read 2459 times)

Hey gang! Well I've been on meds for almost 2 years and still my CD4 is low. I started off at 129 when I was diagnosed with a VL of 59,000. I began on Atripla and bactrum and my VL went to UD within 3 months but my CD4 took over a year to even get to 200.

I switched to Stribild about a year ago now and VL is still UD but my CD4 went to 356 but most recently my labs show it's back down to 298.

I had cancer about 15 years ago and underwent chemo and radiation for about a year. I'm not sure if that could be the cause of the low CD4. I've discussed it with my ID and she wants to take the 'wait and see' approach. I've had several bouts with skin infections and a few severe cold/flu sick days in the last couple months.

I guess I'm frustrated more than anything and wondering if I should be trying or doing something else/more? Ideas? Thanks

Three years since dx and on Atripla. My CD4 is around 282 (dx was 008). Doc says not to expect anymore significant rebound, that 282 is, essentially "fine" as long as VL remains suppressed to undetectable (which it does). She told me that starting off so low (008) and at my age (51) my body wouldn't be creating new Tcells at a big rate anyway.

Forgot to add that she said baseline CD4 is 800-1200 but can range from 5-800 in otherwise healthy people.

Logged

Diagnosed in May of 2010 with teh AIDS.

PCP Pneumonia . CD4 8 . VL 500,000

TRIUMEQ - VALTREX - FLUOXETINE - FENOFIBRATE - PRAVASTATIN - CIALIS

Numbers consistent since 12/2010 - VL has remained undetectable and CD4 is anywhere from 275-325

I was diagnosed almost three years ago. I am on truvada, isentress, bactrim, zithromax and take a multivitamin. When I was diagnosed my cd4 was 33 and at my last doctor visit in October I was up to 185. Shortly after my diagnosis I had a MAC attack and was also keeping cervical cancer at bay both of which I am over. My vl has also remained UD except for one blip and a slight increase when I had that MAC thingy.

Like Drews doctor my doctor also says not to hold my breath for a big rebound due to age, I was 46 when I was dx'd, and other female crap girls my age start to go through. His theory is that as long as I stay UD, and my Cd4 goes up and not down to much then something is working and not to worry to much. He also tells me to expect my CD4 to possibly go down at times especially in the winter time.

Tips: I don't stress to much about it, and just try to take care of myself. Nurse Vampire had the pleasure of giving me a flu shot again this year .

Another thing my doctor told me in the beginning was to take my meds on a regular basis (I succeed most of the time).

Michelle

Logged

How to handle stress like a dog:If you can't eat it or play with it.....then pee on it and walk away

CD4 counts vary by about 50 by the time of the day. The count is also proportional to your body weight - when your body weight increases, you are producing more CD4 cells. I know that from my personal numbers and I've seen it confirmed in papers that CD4 'correlates positively with body weight' while CD4% does not.

The real indicator of your immune system health/balance is CD4% which doesn't vary much with time of day or body weight. It indeed increases very slowly for people that started at a small value.

There are studies (below) that low dose Naltrexone can be used safely as addition to the HIV drugs and that it increases CD4 and CD4% faster than just HIV drugs alone. Discussing that with your doctor will be useless unless you print the studies for him/her. Then you have some chance a non-brainwashed doctor to prescribe it.

The lower the CD4 when starting meds, the longer it'll take to rebound to whatever your normal is. Being in single digits, it took me years to hit the 500 mark where it pretty much remains. Unless you ever had a baseline test before becoming infected, you'll never be sure what your numbers were for comparison.

Wishing you the bestWolfie

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Complacency is the enemy. Challenge yourself daily for maximum return on investment.

cd4 counts can actually vary by 100 pts in any given day -with lower counts in the morning and higher counts in the early evening.

my story, which sounds like others here, should help you see your situation isn't so unusual. it took me 12 yrs to reach undetectable and over 200 cd4. Matter of fact after 21 yrs of meds this month, I'm still lucky to keep hitting near my "normal" of about 315....

... and yet with only those few, I haven't been back in the hospital or even very sick at all since 16 yrs this March. It's not how many cd4s you have but how well they work.

Sadly though there's not much you can do to raise your cd4 except take HAART and hope your immune system recovers more.

you should also be aware that HIV drugs are not equal in terms of how much they raise CD4.

I've seen statements in papers that some HIV drugs toxicity suppresses CD4 increase.

For example, in comparison papers, a regiment based on Integrase Inhibitors (Stribild, Tivicay etc) usually raises CD4 faster than other combos probably because Integrase Inhibitors have less effect on metabolism compared to older drugs.

Being normal to ample will show marginal differences in Cd4 gain, they are more or less comparable.

The low dose naltexone idea has credence in the first 9 months of ARV therapy but the absolute gain is small overall, 10s or 20s of cells, and dimishes with more time on ART.

Integrase inhibitors like raltegravir (Isentress) and elvitegravir (in Stribild) seem to do well at allowing CD4 count to rise. The reason integrase inhibitors allow for new CD4 cells is because they encourage growth of new CD4 cells (by some mechanism, there are theories but no definitive position).

Time is a great healer, and, perhaps like me you will see some jumps now and then and levels in between. This happened to me. Took 6 years to go from sub-200 to 600+.

5% of people will have a usual CD4 count of under 380. Normal is just what shows in the whole population.

you should also be aware that HIV drugs are not equal in terms of how much they raise CD4.

I've seen statements in papers that some HIV drugs toxicity suppresses CD4 increase.

For example, in comparison papers, a regiment based on Integrase Inhibitors (Stribild, Tivicay etc) usually raises CD4 faster than other combos probably because Integrase Inhibitors have less effect on metabolism compared to older drugs.

Some links to credible studies to back up your claims would be nice. It's like you're purposely trying to scare newly diagnosed people and I'm starting to question your motives. I'm watching you again.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Conclusion: Raltegravir intensification modestly impacts viral dynamics and induces a rapid but limited gain in CD4 T cell counts in immunodiscordant patients. Residual viral replication does not seem to be the main cause of unsatisfactory CD4 T cell recovery in these patients.

Link is just the abstract, the full paper's worth a read if that's your kind of thing.

A switch study showing significant gains after 6 months on raltegravir - 448 CD4 cells/mm3 9range 288-575) vs. 322 cells at baseline (range 242-594), but whether this is sustained long term, or makes a difference to health and longevity is unaswered. The interesting thing here is the effect of raltegravir on the thymus, a key part of the immune system

These findings not necessarily generalisable to other integrase inhibitors